[Biological diagnosis of premature rupture of membranes: respective values of diamine oxidase activity compared to vaginal fluid pH (Amnicator)].
OBJECTIVE
To compare the sensitivity (Se), specificity (Spe), positive predictive (PPV) and negative predictive (PNV) values of 2 tests used routinely for suspected premature rupture of the membranes (PROM) and their implication in the management of such cases.


METHODS
From 1 November 1995 to 31 July 1996, 87 patients: 16 with obvious PROM on physical examination (group I) and 71 with suspected PROM (group II) were tested with both DAO and Amnicator. PROM was arbitrary confirmed in group II when delivery occurred within 48 hours after the diagnosis was suspected. The corrected chi 2 test was used to compare both tests results in group II.


RESULTS
In case of obvious PROM, the sensitivity of the DAO and Amnicator tests were 75 and 87.5% respectively. Eleven patients from group II delivered within 48 hours following admission and the 2 tests results were respectively: Se 90.9 and 81.81%, Spe 100 and 83.33%, PPV 100 and 52.63% and PNV 98.36 and 96.15%. DAO gave better results in terms of Spe and PPV (p < 0.05).


CONCLUSIONS
The DAO test remains a reference test when PROM is suspected but when it is not available (during night or week-end), the quite good negative predictive value of Amnicator could avoid unnecessary hospitalisation and permit later DAO test.
De Meeus
J B
JB
Service de Gynécologie, Obstétrique et Médecine de la Reproduction, Hôpital Jean-Bernard, CHU, Poitiers.
Sima Ole
B
B
Bascou
V
V
Magnin
G
G
D000293:Adolescent; D000328:Adult; D006631:Amine Oxidase (Copper-Containing) / Q000032:analysis*; D005240:Feasibility Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis* / Q000201:enzymology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods* / Q000592:standards; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014626:Vaginal Smears / Q000592:standards*
D006631:Amine Oxidase (Copper-Containing)
Diagnostic biologique de la rupture prématurée des membranes: valeurs respectives du test à la DAO et de la mesure du pH vaginal (Amnicator).